Breaking the Cycle of Overmedication: A Digital Tool to Safely Reduce Harmful Prescriptions in Seniors

For seniors, taking multiple medications can be a daily routine. However, this can often lead to adverse effects such as brain fog, falls, and fatigue. Researchers at McGill University have developed an innovative digital tool called MedSafer, which helps clinicians identify and safely reduce unnecessary or even harmful medications in seniors.

MedSafer is designed to work alongside the clinical review process, scanning a patient’s medication list and health conditions to flag potentially inappropriate drugs. In a recent trial involving 725 residents in long-term care homes in New Brunswick, the software helped deprescribe such medications in 36 percent of participants – nearly triple the number when reviews were done without MedSafer.

“We often blame aging for memory loss or mobility issues when the real culprit is the medications,” said Dr. Emily McDonald, lead author and Associate Professor at McGill’s Department of Medicine. “I’ve seen patients go from barely responsive to having conversations again after stopping a sedating medication.”

According to Dr. McDonald, nearly two-thirds of Canadian seniors take five or more medications a day, with an even higher number in long-term care. This phenomenon is known as a “prescribing cascade,” where medications often accumulate over time and are prescribed to counteract the side effects of other drugs.

MedSafer co-developer Dr. Todd Lee explained that this can lead to increased risks of falls, confusion, and hospitalizations, with more interactions and side effects occurring with each additional medication.

The researchers’ ultimate goal is to integrate MedSafer into primary care, addressing overmedication before patients enter long-term care. As Dr. McDonald put it, “This should be the new standard of care for older adults – no one should be on a medication that’s doing more harm than good.”

The study was funded by the Healthy Seniors Pilot Project, a joint initiative between the Public Health Agency of Canada and the Government of New Brunswick.

With MedSafer, clinicians can now have a powerful tool to help their patients break free from the cycle of overmedication. By reducing unnecessary medications, seniors can regain control over their lives, feel more empowered, and live healthier, happier lives.

The battle against cancer has long been an uphill struggle. Despite advances in treatment, the disease still claims too many lives. However, scientists have made a groundbreaking discovery that could change the game – starving tumors to make cancer treatment more effective.

Cancer cells and tumors do not exist in isolation. They interact with their surrounding environment, which is composed of immune cells, connective tissue, blood vessels, and proteins and carbohydrates that provide structure and other supportive functions. Pancreatic ductal adenocarcinoma (PDAC) cells, for instance, use a cellular scavenging process called macropinocytosis to grab extra nutrients from the extracellular matrix.

Macropinocytosis affects the area surrounding the tumor, making connective tissue stiffer and preventing immune cells from reaching the tumor. Researchers at the NCI-Designated Cancer Center at Sanford Burnham Prebys published findings in Cancer Cell demonstrating that blocking macropinocytosis reshapes the tumor microenvironment to be less fibrous and allows more access to immune cells.

The researchers observed that nearby fibroblasts, which typically form connective tissue and produce many components of the extracellular matrix captured during macropinocytosis, are coerced to become cancer-associated fibroblasts (CAF) that help tumors grow. These CAFs provide metabolites and growth signals, as well as helping in other ways.

When macropinocytosis was blocked, CAFs experienced metabolic stress due to deprivation of glutamine, one of the 20 amino acids used to build proteins throughout the body. PDAC relies heavily on glutamine, so CAFs in the pancreatic cancer tumor microenvironment are regularly starved of it.

Preventing macropinocytosis led to a change to a different subtype of CAF marked by the expression of genes that promote inflammation. This altered CAF population had fewer myofibroblasts, which make the tumor microenvironment stiff and fibrotic, and more inflammatory CAFs, which allow for greater access to immune cells.

The research team found significant changes in the tumor neighborhood resulting from preventing macropinocytosis in CAFs. There were fewer deposits of collagen that make the tumor microenvironment stiff or fibrotic, more access for CD4+ and CD8+ T cells to infiltrate the tumor, and vascular expansion, which promotes drug delivery.

The investigators then tested the effects of combining a treatment to block macropinocytosis with immunotherapy and chemotherapy. They found that this combination significantly suppressed tumor metastasis and prolonged mouse survival.

These findings have significant implications for cancer patients, particularly those with PDAC, which is the third leading cause of cancer deaths despite accounting for only three percent of cases. The scientists will continue to explore how to prevent tumors from scavenging energy to reshape the tumor microenvironment into one that makes cancer treatments more effective.

As lead author Yijuan Zhang, PhD, said, “We believe this is a very promising strategy to pursue for developing combination therapies for cancer patients.”

Grapes have long been enjoyed for their sweet taste and refreshing crunch, but recent research has solidified their position as a true “superfood.” A groundbreaking study published in the Journal of Agriculture and Food Chemistry presents a compelling case for why fresh grapes deserve superfood status. Led by renowned resveratrol researcher John M. Pezzuto, Ph.D., this article delves into the scientific evidence supporting grapes’ exceptional health benefits.

The term “superfood” is often used loosely, but what exactly constitutes a superfood? Typically, these foods are rich in natural plant compounds that have been shown to provide health benefits. Mainstream superfoods like berries and leafy greens are commonly associated with a Mediterranean Diet, which emphasizes whole, nutrient-dense foods. Pezzuto’s article sheds light on the broader topic of superfoods and makes a strong scientific case for grapes.

One of the most significant advantages of grapes is their staggering diversity of compounds – over 1,600 have been identified! This includes antioxidants, polyphenols like flavonoids, anthocyanidins, catechins, phenolic acids, and resveratrol. These compounds work synergistically to promote health benefits through antioxidant activity and influencing cellular processes. It’s essential to note that the whole grape, with its unique matrix of compounds, is responsible for these biological effects – not just a single component.

A wealth of scientific literature has been devoted to exploring grapes’ impact on various aspects of human health. The evidence suggests that:

* Grapes have cardiovascular benefits by promoting relaxation of blood vessels and healthy circulation while modulating cholesterol levels.
* Clinical trials demonstrate grapes’ support for brain health, including maintaining healthy brain metabolism and beneficial impacts on cognition.
* Skincare benefits from grapes include enhanced resistance to UV radiation and DNA damage in skin cells.
* Gut health is positively influenced by grape consumption, with modulation of the gut microbiome and increased diversity in the gut.
* Eye health also stands to benefit, with retinal impact via increase in macular pigment optical density.

In the realm of nutrigenomics – the study of foods on gene expression in the body – grape consumption has been shown to positively alter gene expression in relevant body systems. Pezzuto suggests that these activities at the genetic level are likely driving forces behind grapes’ health benefits.

The California Table Grape Commission’s president, Ian LeMay, emphasizes Dr. Pezzuto’s findings: “Based on the science, grapes are indeed a superfood and should be recognized as such.” He encourages using this nomenclature in association with grapes to promote awareness of their exceptional health benefits.

Whether enjoyed for their nutritional value or simply as a healthy snack, consuming fresh grapes is undoubtedly a win-win situation.